Bongomin Felix, Olum Ronald, Nakiyingi Lydia, Lalitha Rejani, Ssinabulya Isaac, Sekaggya-Wiltshire Christine, Ocama Ponsiano, Byakika-Kibwika Pauline
Department of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda.
Department of Medical Microbiology and Immunology, Faculty of Medicine, Gulu University, Gulu, Uganda.
Adv Med Educ Pract. 2021 Mar 12;12:253-262. doi: 10.2147/AMEP.S300265. eCollection 2021.
The coronavirus-2019 (COVID-19) pandemic continues to impose a significant impact on medical education. We aimed to describe the clinical learning experience of undergraduate medical students undertaking internal medicine clerkship during the COVID-19 pandemic at Makerere University, Uganda.
A descriptive, cross-sectional study among medical students in clinical years of study pursuing the Bachelor of Medicine and Bachelor of Surgery undergraduate degree program was conducted in November 2020. Only 3rd (junior clerks) and 5th (senior clerks) year medical students whose internal medicine clerkships were interrupted by the COVID-19 pandemic were studied.
Data of 188 (95%) eligible clinical year students; junior (101, 54.0%) and senior (86, 46.0%) were analysed. Median age was 24 (range: 22-42) years. Majority (70.1%) were male and Ugandan nationals (94.1%). Sixty-four (30.3%) students reported inadequate personal protective equipment, 152 (81.7%) felt at risk of contracting COVID-19, and 127 (67.9%) said it was difficult to observe COVID-19 standard operating procedures. Twenty-two students (11.9%) were discouraged from pursuing a career in internal medicine. Overall, most students reported good or excellent clinical experience pre-COVID-19 era compared to during the COVID-19 era (4.0 vs 3.5, p<0.0001). Senior clerks significantly believed that the time allocated for the rotation was adequate (p<0.0001) and they were able to complete their study objectives (p<0.001), compared to the junior clerks. Senior clerks believed that learning was difficult when combined with junior clerks (p=0.013). About half of the students (51.4%, n=95) reported clinical teaching should remain as it was in the pre-COVID-19 era.
The COVID-19 pandemic has had a significantly negative effect on the clinical learning experience of the students. There is need to review the current teaching and learning methods to suit teaching and learning during pandemics of highly infectious diseases to ensure safe and effective learning experience.
2019冠状病毒病（COVID-19）大流行继续对医学教育产生重大影响。我们旨在描述乌干达马凯雷雷大学在COVID-19大流行期间进行内科实习的本科医学生的临床学习经历。
2020年11月，对攻读医学学士和外科学士本科学位课程的临床学年医学生进行了一项描述性横断面研究。仅研究了内科实习因COVID-19大流行而中断的三年级（初级职员）和五年级（高级职员）医学生。
分析了188名（95%）符合条件的临床学年学生的数据；初级（101名，54.0%）和高级（86名，46.0%）。中位年龄为24岁（范围：22 - 42岁）。大多数（70.1%）为男性且是乌干达国民（94.1%）。64名（30.3%）学生报告个人防护装备不足，152名（81.7%）感觉有感染COVID-19的风险，127名（67.9%）表示难以遵守COVID-19标准操作程序。22名学生（11.9%）不再热衷于从事内科职业。总体而言，与COVID-19时代相比，大多数学生报告在COVID-19之前的时代有良好或出色的临床体验（4.0对3.5，p<0.0001）。与初级职员相比，高级职员显著认为分配给轮转的时间足够（p<0.0001），并且他们能够完成学习目标（p<0.001）。高级职员认为与初级职员一起学习时难度较大（p = 0.013）。约一半的学生（51.4%，n = 95）报告临床教学应保持在COVID-19之前的时代那样。
COVID-19大流行对学生的临床学习体验产生了显著的负面影响。需要审查当前的教学方法，以适应高传染性疾病大流行期间的教学，确保安全有效的学习体验。
